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Phase 2- Gen Med > Rheumatology Drugs > Flashcards

Rheumatology Drugs Flashcards

1
Q

What type of drug is adalimumab?

A

anti-TNF drug

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2
Q

Which conditions have lots of TNF present?

A

Rheumatoid arthritis
Psoriatic arthritis
Ankylosing spondylitis
Juvenile idiopathic arthritis

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3
Q

What is adalimumab commonly prescribed with?

A

Methotrexate

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4
Q

What investigations need to be done before prescribing Adalimumab?

A

TB screen
Chest x-ray
Hepatitis screen

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5
Q

How is adalimumab administered?

A

SM injection every 2 weeks

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6
Q

Give 4 conditions where adalimumab would be contraindicated?

A 
Infection present 
Multiple sclerosis 
Cancer
Lung fibrosis
Heart disease
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7
Q

Give 4 side effects of adalimumab

A 
Injection site pain 
More at risk of infections 
Increased risk of skin cancer
More severe reaction to chickenpox and shingles
Drug-induced lupus
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8
Q

What enzyme does allopurinol inhibit?

A

Xanthine oxidase

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9
Q

What is allopurinol indicated for?

A

Prevention and treatment of recurrent gout
When gout has started to damage the joints
Tophi are present

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10
Q

Give 4 side effects of allopurinol

A 
Skin rashes
Headaches 
Drowsiness
Nausea 
Vomiting
Alteration in taste
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11
Q

Give 3 potential DDIs with allopurinol

A 
Azathioprine 
Mercaptopurine
Ampicillin 
Amoxicillin 
Warfarin
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12
Q

What type of drug is Azathioprine?

A

DMARD

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13
Q

In what conditions are DMARDs indicated?

A

SLE
RA
Polymyositis
Dermatomyositis

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14
Q

What enzyme should be checked before starting azathioprine?

A

TPMT

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15
Q

If the TPMT level is high, what should be done to the dose of azathioprine?

A

Need a higher dose as the drug is broken down quickly

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16
Q

If the TPMT level is low, what should be done to the dose of azathioprine?

A

Lower the dose as the drug is broken down more slowly and there is a higher risk of side effects

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17
Q

Give a DDI of azathioprine

A

Allopurinol

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18
Q

Give 4 potential side effects of azathioprine

A

Nausea, vomiting, diarrhoea, loss of appetite, hair loss, skin rashes, agranulocytosis, liver disease, severe reaction to chickenpox or shingles

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19
Q

What is the main action of bisphosphonates?

A

Slow bone loss to reduce the risk of fractures

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20
Q

Give 2 examples of bisphosphonates

A

Alendronic acid
Zoledronate
Pamidronate

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21
Q

Give 3 common side effects of bisphosphonates

A 
Oesophagitis
Rash 
Sore mouth 
Bone pain 
Muscle pain 
Headaches
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22
Q

Give 3 rare side effects of bisphosphonates

A

Osteonecrosis of the jaw
Esophageal cancer
Femur fractures

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23
Q

What is the mechanism of action of Celecoxib?

A

Selective COX II inhibitor

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24
Q

What type of drug is celecoxib?

A

NSAID

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25
Give 3 contraindications to celecoxib
T3 pregnancy Heart disease GI bleeding Allergy to aspirin or other NSAIDs
26
Give 3 potential DDIs with celecoxib
NSAIDs, alcohol, aspirin, warfarin, prednisolone, fluconazole, lithium
27
Give 4 potential side effects of celecoxib
Rash, cold-like symptoms, dizziness, stomach pain, SOB, stomach bleeds, liver problems, anaemia
28
What is calcitonin used for?
Short term treatment to prevent bone loss after an osteoporotic fracture
29
Give 3 potential side effects of calcitonin
Nausea, vomiting, diarrhoea, abdominal pain, dizziness, headache, taste disturbance
30
When are vitamin D and calcium supplements given?
Alongside osteoporosis medicine
31
What type of drug is ciclosporin?
DMARD
32
What conditions are indicated for ciclosporin?
RA SLE Psoriatic arthritis
33
Give 3 side effects of ciclosporin
Hypertension Hypercholesterolaemia Kidney damage Worse reaction to chickenpox and shingles
34
Give 2 DDIs of ciclosporin
NSAIDs Herbal remedies Grapefruit juice
35
What is colchicine used for?
Acute flare ups of gout
36
Give the 2 main side effects of colchicine
GI upset | Neutropenia
37
Give 2 DDIs of colchicine
Erythromycin | Clarithromycin
38
What type of drug is cyclophosphamide?
Immunosuppressant (alkylating chemotherapeutic drug)
39
In what conditions is cyclophosphamide used in?
Severe RA SLE Vasculitis Myositis
40
Give 5 side effects of cyclophosphamide
``` Nausea More at risk of infections Hemorrhagic cystitis Agranulocytosis Hair loss Mouth ulcers Irregular periods Increased risk of bladder cancer ```
41
What is febuxostat used for?
Long term prevention of gout
42
When is febuxostat not indicated?
Previous MI Severe kidney disease Liver disease Thyroid problems
43
Give 4 possible side effects of febuxostat
Diarrhoea, headaches, skin rashes, nausea, taste disturbance, palpitations, reduced libido
44
Give 3 DDIs of febuxostat
Azathioprine Mercaptopurine Theophylline
45
What type of drug is Hydroxychloroquine?
DMARD
46
What is the action of hydroxychloroquine?
Reduces inflammation Reduces pain Reduces swelling Reduces joint stiffness
47
What specific action can hydroxychloroquine have in lupus?
Reduce the rash associated with lupus
48
What test must be done through treatment on hydroxychloroquine?
Vision tests
49
Give 5 possible side effects of hydroxychloroquine
Rash, nausea, indigestion, diarrhoea, headaches, hair bleaching, hair loss, tinnitus, blurred vision, retinal damage
50
Give 1 DDI of hydroxychloroquine
Antacids
51
What type of drug is infliximab?
ANti-TNF
52
When is infliximab contraindicated?
No active inflammation Current infection History of multiple sclerosis, cancer, heart disease, lung fibrosis
53
Give 5 side effects of infliximab
Rhinorrhoea, headaches, dizziness, flushing, rash, stomach pain, indigestion, agranulocytosis, more severe reaction to chickenpox or shingles, drug-induced lupus
54
What conditions is intravenous immunoglobulin used to treat?
Polymyositis Dermatomyositis Occasionally SLE, vasculitis, antiphospholipid syndrome
55
When is intravenous immunoglobulin contraindicated?
Low levels of IgA
56
Give 4 possible side effects of intravenous immunoglobulin
Chill, headaches, stomach pain, fever, nausea, vomiting, joint pain, tiredness, rash, aseptic meningitis, haemolytic anaemia, hypertension, increased risk of MI and stroke
57
What type of drug is methylprednisolone?
Corticosteroid
58
Why should methylprednisolone not be stopped suddenly?
Adrenal insufficiency (Addisonian crisis)
59
Give 2 contraindications of methylprednisolone
Fungal infection | Diabetes
60
Give 4 side effects of methylprednisolone
``` Fluid retention Dizziness Headache Changes in menstrual periods Myalgia Muscle weakness Stomach pain Bloating Depression ```
61
Give 4 effects of long term steroid use
Cushingoid appearance OSteoporosis Cataracts Diabetes
62
What type of drug is methotrexate?
DMARD
63
How often is methotrexate taken?
Once a week
64
Which supplement is often taken alongside methotrexate?
Folic acid
65
When is methotrexate contraindicated?
Lung fibrosis | Emphysema
66
Give 4 side effects of methotrexate
Nausea, vomiting, diarrhoea, mouth ulcers, hair loss, skin rashes, agranulocytosis, pneumonitis
67
Give 3 DDIs with methotrexate
``` Trimethoprim Septrin Phenytoin Theophylline Alcohol ```
68
What type of drug is mycophenolate mofetil?
DMARD
69
What is mycophenolate mofetil used to treat?
SLE Scleroderma Vasculitis Also used after organ transplantation
70
Give 4 side effects of mycophenolate mofetil
``` Nausea Diarrhoea Stomach pain Agranulocytosis Increased risk of skin cancer Liver disease Kidney disease ```
71
What is the main function of NSAIDs?
Reduce inflammation | Reduce pain
72
Give 3 contraindications of NSAIDs
``` High risk of GI bleed or ulceration Previous MI Peripheral vascular disease Hypertension Hypercholesterolaemia Diabetes Kidney disease ```
73
Why should children not take aspirin?
Risk of Reye's syndrome
74
Give 3 examples of NSAIDs
Ibuprofen Naproxen Aspirin
75
What is the function of paracetamol?
Pain relief
76
Why is paracetamol so dangerous in overdose?
Metabolites cause serious liver damage
77
When is Raloxifene used?
To treat osteoporosis of the spine in postmenopausal women who have had fractures.
78
Give 3 contraindications of Raloxifene
Older women History of DVT History of uterine cancer Liver disease
79
Give 3 side effects of Raloxifene
Hot flushes, leg cramps, swollen ankles, flu-like symptoms DVT
80
What type of drug is Rituximab?
Biological therapy
81
Give 3 contraindications of Rituximab
``` No active disease Infection present Pregnant Breastfeeding B-cell levels low Seronegative RA ```
82
Give 3 side effects of Rituximab
``` Fever Wheeze Rash Postural hypertension Higher risk of infections Progressive multifocal leukoencephalopathy ```
83
When are steroid injections used?
Painful joints in: RA Osteoarthritis
84
What type of drug is sulfasalazine?
DMARD
85
Give 3 side effects of sulphasalazine
Nausea, diarrhoea, stomach pain, dizziness, headaches, skin rashes, orange urine, yellow tears, abnormal LFTs and FBC, fall in sperm count

Phase 2- Gen Med (7 decks)

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